The major goal of this research is to study the relationship between the extent of family history (FH) of alcoholism and outcome of treatment for alcoholism using state-of-the-art methods for defining and measuring both FH status and treatment outcome. It is hypothesized that family history positive (FH+) alcoholics have a double set of deficits to overcome in their bid for sobriety and will have a worse treatment outcome over time than will family history negative (FH-) alcoholics. FH+, as compared to FH-, alcoholics may be impaired not only by a more severe form of alcoholism, but also may be developmentally impaired from having grown up in an alcoholic family. Specifically, 180 male alcoholics in an inpatient alcoholism treatment program will be divided into three FH groups of 60 each according to the alcoholism of their parents: both parents alcoholic, father only alcoholic, and no alcoholic parents. FH statue will be determined from a convergence of the reports of the subject, the subjects's sibling and the subject's mother or other knowledgeable parent generation relative. Conservative criteria for both the presence and the absence of parental alcoholism will be used to minimize false positives and, most importantly, false negatives. These three groups of alcoholics will be followed for 18 months to determine outcomes after inpatient treatment. Treatment outcome evaluation will include careful planning to minimize subject attrition and measurement of multiple life health outcomes. Alcoholics will be breath tested to determine whether they are alcohol-free when interviewed, and corroborating evidence from collateral reports and biochemical markers will be used with the alcoholics' self-reports in a convergent validity approach to the measurement of drinking and related behavior. A second goal of this project is to contribute to the growing literature on differences between FH+ and FH- alcoholics in course and severity of alcoholism, treatment entry psychosocial adjustment, and life history experiences and adaptation. To this end, a multidimensional assessment will be conducted while the alcoholic is in the hospital and cover the following domains on which the three FH groups will be compared: family background and childhood history, current and past cognitive functioning, drinking and related behavior, social and vocational adjustment, and mental and physical health. Finally, a pilot study will compare FH+ alcoholics with their nonalcoholic adult male biological siblings on this multidimensional assessment battery to better understand this selective vulnerability.